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Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person

In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design i...

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Autores principales: Rance, Susanna, Westlake, Debra, Brant, Heather, Holme, Ingrid, Endacott, Ruth, Pinkney, Jonathan, Byng, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303774/
https://www.ncbi.nlm.nih.gov/pubmed/32596418
http://dx.doi.org/10.1177/2333393620930024
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author Rance, Susanna
Westlake, Debra
Brant, Heather
Holme, Ingrid
Endacott, Ruth
Pinkney, Jonathan
Byng, Richard
author_facet Rance, Susanna
Westlake, Debra
Brant, Heather
Holme, Ingrid
Endacott, Ruth
Pinkney, Jonathan
Byng, Richard
author_sort Rance, Susanna
collection PubMed
description In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 health care professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient–carer relationship contrasted with accompanying persons’ varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relationship with the patients. Taking a relationship-centered approach could improve the attention to accompanying persons as co-producers of health care and participants in decision-making.
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spelling pubmed-73037742020-06-26 Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person Rance, Susanna Westlake, Debra Brant, Heather Holme, Ingrid Endacott, Ruth Pinkney, Jonathan Byng, Richard Glob Qual Nurs Res Single-Method Research Article In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 health care professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient–carer relationship contrasted with accompanying persons’ varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relationship with the patients. Taking a relationship-centered approach could improve the attention to accompanying persons as co-producers of health care and participants in decision-making. SAGE Publications 2020-06-18 /pmc/articles/PMC7303774/ /pubmed/32596418 http://dx.doi.org/10.1177/2333393620930024 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Single-Method Research Article
Rance, Susanna
Westlake, Debra
Brant, Heather
Holme, Ingrid
Endacott, Ruth
Pinkney, Jonathan
Byng, Richard
Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title_full Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title_fullStr Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title_full_unstemmed Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title_short Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person
title_sort admission decision-making in hospital emergency departments: the role of the accompanying person
topic Single-Method Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303774/
https://www.ncbi.nlm.nih.gov/pubmed/32596418
http://dx.doi.org/10.1177/2333393620930024
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